Background: Health care costs of the offspring of mothers addicted to cocaine are three times higher than those of children not exposed to cocaine during gestation. Aim: To calculate the health care costs of the offspring of addict mothers that consumed cocaine during gestation. To verify the diseases or health conditions in these children, that generated the expenses. Material and methods: One hundred offspring of addict women consuming cocaine base paste were studied. The health care expenses generated by hospital admissions and ambulatory follow) up were calculated. Expenses were expressed in Chilean pesos, according to the value at June, 2000. The fares of the South Orient Metropolitan Health Service were used as a reference. Results: Twenty four of the 100 children were lost from follow up. Among the 76 followed children, 48 were admitted to hospitals in 2.3 (range 1.2) occasions. Mean hospital stay was 21.7 clays (range 1-186) and hospital mortality was 4%. Mean expense per hospital discharge was $1,556,098 and per patient was $3,457,995. The monthly expenses per children during ambulatory follow up were $120,372 that increased to $395,200 if family placing was added. Conclusions. These figures confirm that health care expenses of cocaine addicts offspring are more than three times the cost of a normal child. Primary and secondary prevention of cocaine addiction is urgently needed.